子宫颈癌根治性子宫切除术后下尿路症状及相关因素分析  

Analysis of lower urinary tract symptoms and related factors following radical hysterectomy for cervical cancer

作　　者：安方[1] 汪莎 王志启[1] 孙秀丽[1] 吴令英[2] 吕秋波[3] 吕爱明[3] 温宏武[4] 韩劲松[5] 吴玉梅[6] 高雨农[7] 刘青[8] 王素美[9] 李红霞[10] 王鲁文 王彦龙 吴瑞芳[13] 李环[13] 王建六[1] AN Fang;WANG Sha;WANG Zhiqi;SUN Xiuli;WU Lingying;LV Qiubo;LV Aiming;WEN Hongwu;HAN Jinsong;WU Yumei;GAO Yunong;LIU Qing;WANG Sumei;LI Hongxia;WANG Luwen;WANG Yanlong;WU Ruifang;LU Huan;WANG Jianliu(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院妇产科,北京市女性盆底疾病研究重点实验室,北京大学医学部女性盆底疾病研究中心,北京大学人民医院女性盆底疾病诊疗中心,100044 [2]中国医学科学院北京协和医学院肿瘤医院 [3]北京医院 [4]北京大学第一医院 [5]北京大学第三医院 [6]首都医科大学附属北京妇产医院 [7]北京大学肿瘤医院暨北京市肿瘤防治研究所 [8]甘肃省妇幼保健院 [9]首都医科大学附属北京朝阳医院 [10]首都医科大学附属北京世纪坛医院 [11]郑州大学第三附属医院 [12]厦门市妇幼保健院 [13]北京大学深圳医院

出　　处：《中国妇产科临床杂志》2021年第4期398-401,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：北京市科技计划课题资金支持项目(D151100001915003);科学技术部国家重点研发计划(2018YFC2002204)。

摘　　要：目的了解子宫颈癌根治性子宫切除术后患者下尿路症状患病情况及其相关因素。方法选择2012年1月至2015年3月在全国13家研究中心接受PiverⅢ型子宫切除的690例宫颈癌患者,并按照年龄和体质指数匹配妇科门诊无手术史良性疾病患者690例作为对照组,采用女性下尿路症状国际尿失禁标准问卷(ICIQFLUTS)和膀胱过度活动症评分(overactive bladder symptom score,OABSS)对两组患者进行问卷调查。结果宫颈癌组下尿路症状患病率(78.3%,540/690)与对照组(78.7%,543/690)相似(P>0.05)。宫颈癌组储尿期症状患病率(66.2%,457/690)低于对照组(75.5%,521/690)(P<0.05),而排尿期症状(52.3%,361/690)和膀胱过度活动症(overactive bladder symptom,OAB)(14.5%,100/690)患病率显著高于对照组(24.1%,166/690;8.8%,61/690)(P<0.05)。单因素分析显示,腹腔镜手术、术中切除宫旁长度或阴道长度>3 cm与排尿期症状、OAB患病相关(P<0.05)。Logistic分析显示,腹腔镜手术是排尿期症状(OR=2.380,95%CI:1.664~3.405)和OAB的危险因素(OR=1.972,95%CI:1.155~3.367)。结论宫颈癌患者根治性子宫切除术后排尿期症状及OAB患病率升高,可能与切除较多的宫旁和阴道组织有关。Objective To investigate the morbidity of lower urinary tract symptoms(LUTS) in patients after Piver Ⅲ radical hysterectomy(RH Ⅲ)for cervical cancer and analyze associated factors. Methods From January 2012 to March 2015, 690 patients who received RH Ⅲ in 13 hospitals were selected, and 690 patients with benign gynecological diseases(no surgical history) were matched according to age and BMI. Both groups were surveyed by questionnaires using the ICIQ-FLUTS and OABSS. Results The incidence of LUTS in the cervical cancer group(78.3%, 540/690) was similar to that in the control group(78.7%, 543/690)(P > 0.05). The prevalence of storage symptoms in the cervical cancer group(66.2%, 457/690) was lower than that in the control group(75.5%, 521/690)(P < 0.05), while the prevalence of voiding symptoms in the cervical cancer group(52.3%, 361/690) and OAB(14.5%, 100/690) was significantly higher than that in the control group(24.1%, 166/690;8.8%, 61/690)(P < 0.05). Univariate analysis showed that laparoscopic surgery, resection of cardinal-ligament and uterosacral-ligament length or vaginal length > 3 cm was associated with voiding symptoms and OAB(P < 0.05). Logistic analysis showed that laparoscopic surgery was a risk factor for voiding symptoms and OAB(OR = 2.380, 95% CI : 1.664-3.405;OR =1.972, 95%CI : 1.155-3.367). Conclusion After RH Ⅲ, the morbidity of voiding symptoms and OAB was increased, and it may be related to excision of more tissue of parametrium and vagina.

关 键 词：子宫颈癌 根治性子宫切除术 下尿路症状 尿失禁 膀胱过度活动症 

分 类 号：R737.33[医药卫生—肿瘤]